Grant: Travel Awards - Institute Community Support

We consulted a group of pan-Canadian experts to establish consensus on practice-based metrics that characterize quality of care for older primary care patients. We aimed to establish a measurable set of indicators that can be examined using secondary health administrative data. To do this, we conducted a two-round RAND/UCLA Appropriateness Method (RAM) study and recruited 10 clinicians and researchers with expertise relevant to the primary care of elderly patients. Informed by a literature review, the first RAM round evaluated the appropriateness and importance of candidate quality measures in an online questionnaire. Technical definitions were developed for each endorsed indicator to specify how the indicator could be operationalized using health administrative data. In a virtual meeting, the expert panel offered feedback on the technical specifications for the endorsed indicators. Panelists then completed a second questionnaire to rate each indicator and technical definition on the same criteria. We used statistical integration to combine technical expert panelists' judgements and content analysis of open-ended survey responses. Our literature search and internal screening resulted in 61 practice-based quality indicators for rating. We developed technical definitions for indicators endorsed in the first questionnaire (n=55). Following the virtual synchronous meeting and second questionnaire, we achieved consensus on 12 practice-based quality measures across four Priority Topics in Care of the Elderly. The endorsed indicators provide a framework to characterize practice- and population-level encounters of family physicians delivering care to older patients and will offer insights into the outcomes of their care provision. Future work will refine and operationalize the technical definitions established through this process to examine primary care provision for older adults in a particular context (Ontario, Canada).